Ophthalmology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal.
Faculty of Medicine of University of Porto, Porto, Portugal.
Ophthalmic Res. 2022;65(4):446-454. doi: 10.1159/000509553. Epub 2020 Jun 19.
Central serous chorioretinopathy (CSCR) is a chorioretinal disorder resulting from choroidal hyperpermeability. Its comorbidities as hypertension, coronary disease, and psychological stress, suggest that it might reflect a more generalized vascular dysfunction.
The aim of the study was to assess the cerebrovascular regulation integrity, using cerebral autoregulation (CA), carbon dioxide vasoreactivity (VR), and neurovascular coupling (NVC) in CSCR.
This observational pilot study included 20 CSCR patients and 14 age- and sex-matched controls. A State-Trait Anxiety Inventory (STAI) inquiry was full-filled. Continuous measurement of cerebral blood flow velocity (CBFV), arterial blood pressure, heart rate, and end-tidal carbon dioxide was performed. VR was assessed during hypercapnia (inhaling carbogen gas) and hypnocapnia (hyperventilation). For NVC, the CBFV relative increase during mental activation using the N-Back Task was calculated.
No significant differences in systemic hemodynamic parameters, CA or VR, were found between both groups. During the NVC performance, the average CBFV rise during mental stress was significantly lower in CSCR (p = 0.011). A significant negative correlation was found between STAI scores and NVC.
CSCR patients presented a significantly impaired cerebral NVC compared to controls, supporting the theory of a potential systemic vascular dysfunction. Stress could be related to this NVC impairment.
中心性浆液性脉络膜视网膜病变（CSCR）是一种源于脉络膜通透性增加的脉络膜视网膜疾病。其合并症如高血压、冠心病和心理压力表明，它可能反映了更广泛的血管功能障碍。
本研究旨在评估 CSCR 患者的脑血管调节完整性，使用脑自动调节（CA）、二氧化碳反应性（VR）和神经血管耦合（NVC）。
本观察性初步研究纳入了 20 例 CSCR 患者和 14 名年龄和性别匹配的对照者。完成状态-特质焦虑量表（STAI）调查。连续测量脑血流速度（CBFV）、动脉血压、心率和呼气末二氧化碳。在高碳酸血症（吸入碳氧混合气）和低碳酸血症（过度通气）期间评估 VR。对于 NVC，使用 N-Back 任务计算精神激活期间 CBFV 的相对增加。
两组之间的系统血液动力学参数、CA 或 VR 无显著差异。在 NVC 性能期间，CSCR 患者的精神压力下平均 CBFV 升高明显较低（p = 0.011）。STAI 评分与 NVC 呈显著负相关。
CSCR 患者的脑 NVC 明显受损，与对照组相比，支持潜在系统性血管功能障碍的理论。压力可能与这种 NVC 损伤有关。
